Expression Levels of Plasma Exosomal lncNORAD in Bladder Cancer and Its Clinical Diagnostic Value
Objective To evaluate the diagnostic efficacy of plasma exosomal lncNORAD as a tumor marker for bladder cancer(BCa)by examining its expression levels in BCa patients and analyzing the correlation with clinical pathological characteristics.Methods This retrospective study.100 BCa patients diagnosed between October 1,2021,and October 1,2023,at Tongji Hospital,Tongji University were randomly selected as the patient group(76 males,24 females,mean age 71±10 years).In the same period,40 patients with benign urinary system diseases(benign disease group;33 males,7 females,mean age 64±9 years)and 70 healthy individuals undergoing routine check-ups(control group;53 males,17 females,mean age 45±12 years)were included.Plasma exosomes were extracted using an exosome extraction kit,and morphologically and molecularly were characterized by transmission electron microscopy,nanoparticle tracking analysis,and Western blotting.Total RNA from plasma exosomes was extracted,and the expression level of exosomal lncNORAD was detected by real-time quantitative polymerase chain reaction.In the BCa patient group,patients were divided into high expression and low expression groups based on the median relative expression level of lncNORAD.The x2 test was used to compare the relationship between lncNORAD expression and clinical pathological characteristics,and the receiver operating characteristic(ROC)curve was used to evaluate its diagnostic efficacy for BCa.Results The expression level of plasma exosomal lncNORAD in the patient group was significantly higher than that in the control group(P＜0.001)and the benign disease group(P＜0.001).High expression of lncNORAD was closely related to TNM stage(P=0.001,x2=10.187),lymph node metastasis(P=0.003,x2=8.575),tumor grade(P=0.006,x2=7.440),and nuclear matrix protein 22(NMP22,x2=5.844)(P=0.016).ROC analysis showed that the area under the curve(AUC)for diagnosing BCa with plasma exosomal lncNORAD was 0.828(95％CI 0.772-0.883).The diagnostic efficacy was further improved when exosomal lncNORAD was combined with the conventional marker NMP22(AUC=0.866,95％CI 0.815-0.916).Conclusion The upregulation of lncNORAD in plasma exosomes of BCa patients is associated with multiple clinical pathological characteristics,indicating its potential as a diagnostic biomarker for BCa.
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